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Gluten Sensitivity

Understanding Non-Celiac Gluten Sensitivity

Non-celiac gluten sensitivity (NCGS) is a form of gluten intolerance that causes an adverse reaction to gluten without the serious health effects of celiac disease. This is a widespread disorder, potentially affecting 18 to 20 million Americans. It is about six times more common than celiac disease.

Non-Celiac Gluten Sensitivity Symptoms

People with gluten sensitivity experience symptoms that are similar to irritable bowel syndrome (IBS). These include:

Abdominal pain

Indigestion

Bloating

Nausea

Vomiting

Diarrhea

It can also cause headaches, joint pain, numbness in extremities, and difficulty thinking. These symptoms may appear several hours after eating gluten. They subside when gluten is removed from the diet.

How Does Gluten Sensitivity Work?

The medical community is still investigating the mechanism by which gluten causes symptoms in sensitive individuals. Apparently, people with NCGS experience a generalized (innate) immune response in which the body treats gluten as a foreign protein that needs to be destroyed. This reaction can cause an inflammatory response that temporarily affects the intestines and other tissues in the body. Because gluten sensitivity does not cause an autoimmune response, the body does not attack its own tissue. This is also not a food allergy, in which the body begins creating antibodies that are tailored to a specific allergen.

How Is Non-Celiac Gluten Sensitivity Diagnosed and Treated?

There is no definitive test for gluten sensitivity. It can occur in people with or without the genes that are linked to celiac disease, and in individuals who test negative for wheat allergies. A stool test for antigliadin IgA antibody is available from a few labs in the U.S. to check for an immune response to gliadin (one form of gluten found in wheat). At this time, this test is not considered specific or sensitive enough to conclude that an individual has non-celiac gluten sensitivity. It may show antibodies in people who have no symptoms of gluten sensitivity, and many individuals with known gluten sensitivities do not test positive for antigliadin antibodies.

NCGS is still a diagnosis that is reached by ruling out other possible health conditions with similar symptoms and through an elimination diet. Testing for celiac disease, including an intestinal biopsy and genetic test, is particularly important. Individuals with CD may have family members who are also at risk and need to be screened. Once other conditions have been ruled out, individuals with gluten sensitivity can move forward with the lifestyle changes that will improve their health. The treatment for non-celiac gluten sensitivity is to avoid eating foods that contain gluten.